the west nile virus patient
i don’t know which side i was on.
her family wanted to keep her a full code. even without elaboration, i think i know exactly why.
her doctors were persistent about changing her code status. they want that DNR, and i know exactly why.
in 2006, she got infected with west nile virus. i don’t know where she got it. if i remember correctly that was the time i heard all about it in the news here. i didn’t have the guts to ask her daughters if she was here in the US or in vietnam (or maybe cambodia?) when the pesky mosquito had a go at her blood.
anyway, encephalitis and seizures turned her into this creepy looking woman. she stuck her tongue out most of the times, that it looked so dry no matter what. she was very contracted and did nothing much but drool and shake her head constantly. no sounds, no looks of recognition. just a breathing body with diaper and feeding tube, constantly sweaty and helpless like a newborn baby.
her daughters took such good care of her. you can tell by the fact that she had no skin breakdown and she was very clean and well nourished. the four of them usually come at around 8 and they work with her quietly, like members of an orchestra who knew their responsibilities were important as a whole, but insignificant by itself. they would take turns in talking to her in their native language. then, they gather around her bed and offer their prayer. after they kiss her goodnight, they would ask for the nurse and report what they have done.
there is something about being told “she’s all clean now and we just turned her” that is somehow intimidating. like i am supposed to feel like i was not doing my job. but that is a post for another day.
not to digress, and to put it bluntly, the healthcare people don’t seem to see the point of her being a full code. if her heart stopped and everything was done to make it work again, aside from it being a long process, it also seemed like an act of futility. after all, what is a beating heart if it is inside a person staring blankly, curled into a ball, helpless? “vegetable” they say.
the family did not say, but i think the idea is that, it didn’t matter to them that she was just there doing nothing. what mattered to them was that she was there.
a couple of days ago, they finally caved in and signed the DNR form. the doctors must have felt victorious, the family must have felt powerless.
it took weeks for them to decide, and i don’t blame them. things like these are not easy. they never were, and they never will be.
Sometimes, like in this case, I wonder if it isn’t more for the sake of those giving care that the person is kept alive. The family feels like it’s doing something, even if it’s caring for a shell.
I’m glad they signed the DNR. It’s a step forward, as hard as it is for them. Sometimes, it’s just time to let go.
Comment by Kit — May 26, 2008 @ 7:15 am
It makes me so upset when families are pushed into DNRs. No matter what I think about “what I would do” the bottom line is that the family has to go home and be at peace with what they have decided. To me that patient is just one of thousands I will take care of in my career. To them, it is their mom, their dad, grandma, etc..
A sad day indeed.
Comment by Heidi — May 26, 2008 @ 7:15 am
her daughters sound like wonderful caring women. it makes me sad that if something should happen, they have to say goodbye. i’m sure it was not an easy choice for them to make.
Comment by kimmyk — May 26, 2008 @ 10:50 am
Some things take a while to learn.
Comment by shrimplate — May 27, 2008 @ 1:15 pm
It’s very difficult for the family sometimes. Also being from another country they might have a different view on DNR’s the we in the US. It could be a cultural difference.
I helped to take care of a man with West Nile virus at the hospital. He was in a bit better condition then the woman you described. He seemed be making some progress, more cognitively aware, and taking a few steps with the P.T.’s help. Unfortunately he took a turn for the worse, and died. I have heard of West Nile virus on T.V., but didn’t know it could be deadly.
Comment by Awake In Rochester — May 27, 2008 @ 8:08 pm
excuse me,
can I know what is DNR?
is it a kind of process that make the patient die?
Theodora-Malaysia
Comment by Theodora Voon — June 2, 2008 @ 2:19 am
Please dont let things like that make you feel like you arent doing your job. This past week, nurses that I have grown to know over the last three years were happy to leave Sharon in my hands to be her gofer, and help her out with little stuff because they were truly at full capacity all week long,busy busy,running, and I know that by now they trust me, and know that I would use the call button in a heart beat. When Ardis was alive and in a nursing home, I did feel like the job which used to be mine alone (cleaning, and turning)had been contracted out, and being paid for by her retirement money, so I was kind of a hardass especially about finding poop on her, that never went over well, but just because those daughters have had to learn to care for their mom, doesn’t reflect on your excellence in any way. Love, Bobby
Comment by Bobby — June 3, 2008 @ 12:11 pm